48 SERUM C-REACTIVE PROTEIN AS AN INDICATOR OF SURVIVAL AFTER SURGERY FOR ADRENAL METASTASIS FROM MULTIPLE PRIMARY SITES

Abstract

You have accessJournal of UrologyAdrenal1 Apr 201348 SERUM C-REACTIVE PROTEIN AS AN INDICATOR OF SURVIVAL AFTER SURGERY FOR ADRENAL METASTASIS FROM MULTIPLE PRIMARY SITES Hideki Takeshita, Hitoshi Masuda, Kazutaka Saito, Hajime Tanaka, Yoshinobu Komai, Yasuyuki Sakai, Fumitaka Koga, Junji Yonese, Akira Noro, Satoru Kawakami, Takumi Yamada, Yasuhisa Fujii, and Kazunori Kihara Hideki TakeshitaHideki Takeshita Tokyo, Japan More articles by this author , Hitoshi MasudaHitoshi Masuda Tokyo, Japan More articles by this author , Kazutaka SaitoKazutaka Saito Tokyo, Japan More articles by this author , Hajime TanakaHajime Tanaka Tokyo, Japan More articles by this author , Yoshinobu KomaiYoshinobu Komai Chiba, Japan More articles by this author , Yasuyuki SakaiYasuyuki Sakai Chiba, Japan More articles by this author , Fumitaka KogaFumitaka Koga Tokyo, Japan More articles by this author , Junji YoneseJunji Yonese Tokyo, Japan More articles by this author , Akira NoroAkira Noro Saitama, Japan More articles by this author , Satoru KawakamiSatoru Kawakami Saitama, Japan More articles by this author , Takumi YamadaTakumi Yamada Saitama, Japan More articles by this author , Yasuhisa FujiiYasuhisa Fujii Tokyo, Japan More articles by this author , and Kazunori KiharaKazunori Kihara Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1424AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The adrenal gland is a frequent site of dissemination for certain types of tumors. Recently, several investigators reported prognostic factors for adrenalectomy for adrenal metastasis, e.g., tumor type, size of metastasis, and time to adrenal metastasis. C-reactive protein (CRP) is well known as a prognostic factor for many cancers in a variety of primary sites. We investigated the prognostic impact of preoperative CRP on survival after adrenalectomy for adrenal metastasis. METHODS Fifty-one patients undergoing adrenalectomy for adrenal metastasis were identified in a multi- institutional database and analyzed. The Kaplan-Meier method was used to estimate survival rates and the Cox proportional hazards model was used to evaluate the impact of preoperative parameters, including CRP level, on overall and progression-free survivals. We used the following preoperative parameters as variables for analysis: age, sex, laterality, cancer origin, operative procedure, tumor size, CRP level, albumin level, lactate dehydrogenase level, hemoglobin level, solitary/multiple disease, synchronous/metachronous disease, and time between treatment of the primary lesion and adrenalectomy. RESULTS Out of 51 adrenalectomies, 11 were gasless laparoendoscopies and 40 were open procedures. Primary sites were 17 kidneys, 17 lungs, and 17 others. During a median follow-up time of 23 months (range, 1-97), 24 patients experienced disease progression and 14 died. One-, three-, and five-year overall survivals were 97, 73, and 51%, respectively. One- and three-year progression-free survivals were 60 and 38%, respectively. Non-renal origin, larger tumor size, shorter time to adrenal metastasis, and higher CRP levels (≥10 mg/L) were associated with poor survival. High CRP (≥10 mg/L) remained the sole independent predictor of poor survival on multivariate analysis. When patients were stratified into two groups by CRP level groups (<10 and ≥10 mg/L), both overall and recurrence-free survivals differed significantly (p = 0.002 and 0.027, respectively) (Fig A, B). CONCLUSIONS Serum CRP level can be considered an indicator of survival after surgery for adrenal metastasis, irrespective of tumor type. Given this, it can provide useful decision-making information. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e19-e20 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hideki Takeshita Tokyo, Japan More articles by this author Hitoshi Masuda Tokyo, Japan More articles by this author Kazutaka Saito Tokyo, Japan More articles by this author Hajime Tanaka Tokyo, Japan More articles by this author Yoshinobu Komai Chiba, Japan More articles by this author Yasuyuki Sakai Chiba, Japan More articles by this author Fumitaka Koga Tokyo, Japan More articles by this author Junji Yonese Tokyo, Japan More articles by this author Akira Noro Saitama, Japan More articles by this author Satoru Kawakami Saitama, Japan More articles by this author Takumi Yamada Saitama, Japan More articles by this author Yasuhisa Fujii Tokyo, Japan More articles by this author Kazunori Kihara Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...